AML Journal 6

Jumping Off The Gravy Train
May 7, ’12

This past week I have been out of the business world.  Although I am still tethered by technology via emails and texts,  I find I can let go of the business world.  I don’t miss it as much.

Some people can’t live outside work.  My uncle can’t.  Business is his life.  He gets depressed when he is not making deals.

But I can leave it all behind.  Well, as long as I have money to provide food, shelter, books and entertainment.

AML Journal 5

This is Just the Start
May 7, ’12

In the midst of all this, I just realized this crazy schedule is not going to end anytime soon.

The patient has responded as expected to the induction therapy. 6 days of 22 hour chemo. 22 hours of chemo meds flowing into my mother’s body. 3 hours of rest and another cycle begins. 5 to 6 days of this. Her hematologist says breast cancer chemo is not even a pinky finger of our patient’s treatment.

Our patient’s blast cells are down to zero, meaning the immature white blood cells are gone on the surface.  The second induction therapy is needed after a month to wipe out any leukemia at the cellular level. The side effect is that the platelet count also dropped to very dangerous levels. So the new problem is to find blood donors since the hospital ran out of stock of the blood type of the patient.

I think for any person who has leukemia, blood donors need to be identified early on.
It doesn’t seem to end.  The patient is recuperating, rebuilding her strength for the second chemo session.  That is another month of hospital stays.  And after the second one, there will be more tests.

I think I have to condition myself to the fact that this could take almost a year before things return to my normal routine. 

AML Journal 4

Induction Therapy
Apr 28, ’12

The medical journals stress that induction should be started as soon as possible after diagnosis.  With the patient having a mild infection, it is of course necessary to clear the infection before chemo starts.  However, it seems one must not be too complacent with this.  One must ask the doctor the risk of waiting for the infection to clear and then having the platelet count drop to a point where chemo would be very dangerous.  One should insist and ask the risks of waiting for full clearance of the infection or going ahead with chemo with slight infection. 

The degradation is really fast.  A 4 day delay has worsened the patient’s blood count.
During this time, it is best to be hopeful and check out treatments after the induction therapy.  For the succeeding therapy termed as consolidation therapy; the family should research what subtype of AML the patient has.  Certain subtypes respond well to stem cell therapy while others are ok with chemo. Our patient had M1.

There are two kinds of stem cell transplants.  Allogeneic is stem cells from a donor preferably a sibling.  Children have less chances of a match due to input from the other parent.  Autologous is where the patient’s own blood is “cleansed” so to speak of the leukemia and retransfused into the patient’s body. There is a greater risk for rejection in an allogeneic transplant though. While in an autologous transplant, there is also a great probability that the “cleansing” will not be thorough enough and the AML will recur.

If chemo is the choice for the consolidation therapy, more chemo (different medicines) is scheduled after the induction therapy.

Induction therapy usually leads to complete remission, meaning blood levels return to normal.  However this is not a guarantee.  There is an 87% chance of complete remission for patients above 65.  If no complete remission is achieved after the induction therapy, a second induction therapy might need to be scheduled.

AML Journal 3

Acute Myeloid Leukemia
Apr 25, ’12

This seems a good time to note down our experiences with this particular disease that concerns the blood, specifically the bone marrow.

I need to familiarize myself with normal levels of hemoglobin, white blood cells and platelets as it seems the doctors presume you know what they mean when they throw figures at you.

it seems there is no early time to catch this disease because it being acute, it develops so fast that by the time you realize something is wrong, you’ve got full blown AML.  

The tests that finally confirmed AML was the bone marrow extraction done under local anesthesia.  I saw the doctor insert the needle and jiggle it around.  Oh, so that’s how they do it.  So different from just injecting straight away.  She sort of like injected a little at a certain angle, then jiggled the needle to continue injecting at another angle and so on.  Interesting.

The extraction was done on day 2 of confinement.  In between, blood and platelet transfusions were immediately ordered to stabilize the condition of the patient.  
The next step was to schedule surgery for insertion of portacath (portable catheter), in preparation for chemo sessions and expected additional transfusions.  

Day3 of the confinement, the doctors held a conference with the family.  Aw gee, they were kinda tiptoeng around.  Unlike the local doctor – who blurted out his educated guess immediately even without test results.  I don’t know which is better; the shock factor or the roundabout discussion where you feel they’re not telling you everything.  But because of the local doctor’s comment, I was able to research a little about leukemia.  And be a little prepared.

A course of action was presented and agreed upon.  And so we wait for the next step.  Not as straightforward as in the textbooks since a lot of factors came up.  A mild infection that has to be treated before chemo can begin.  Induction therapy – i believe is the official name of this chemo treatment.

AML Journal 2

Thoughts
Apr 24, ’12

I am waiting for my lunch order to arrive, here at the hospital cafeteria.  The doctor’s opinion was for me to postpone the trip.  I thought about it.  But after hearing the boys talk, I am now comfortable with the decision to go through with the trip albeit with some adjustments on my part.

The boys are excited and looking forward to it.  In a way I am looking forward to being with my family too, away from the current problems.  Even for just a few days, I think that would do much to boost my energy levels.  I need a break from medical terms.  

These past few days, when one is more in tune with emotions, things revert to basic.  

I think of my family of course, but not all the time.  I also think of myself.  I savor the wonderful piano music from the piano player in the lobby. I savor the good boneless bangus (milkfish) for lunch now.  I savor the jokes from O.

Taking in the moment while looking forward to tonight.

AML Journal 1

I will also be organizing my journals on Acute Myeloid Leukemia

It Happens
Apr 23, ’12
The past ten days have been absolutely crazy.  Diagnosis of a major illness for my mom, minor surgery for another family member and an upcoming trip with the family.

A thought did strike me that people might say its bad luck, or maybe karma?  But I myself didn’t think of it that way.  These things happen.  I adjust.  I might have had a few hours of emo thing but I think that was necessary to let out the stress.  After some tears, I usually feel better.  Tears are therapeutic for me.  Of course I had to warn the husband so he wouldn’t be alarmed or think he was the cause.  A few moments before the dam broke, I told him I would be crying and that it had nothing to do with him but more like my body’s way of coping with the current pressures.

A couple of days of hassle and I think everything’s ok.  A few lost opportunities but it can’t be helped. A small price to pay for peace of mind.

I am ok now.  I have taken it all in.  It doesn’t seem so bad, in the bigger scheme of things.

Back to School

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The first week just flew. I, who did not have much expectations, was caught in the web of learning. I could just learn for learning’s sake, but I was actually learning something I could use in my life.

An 18 month course on entrepreneurship is the new challenge. There were 31 of us during the orientation but we became 28 when classes started. I was one of the oldest. Only one was older than me. Most of my classmates were in their 30s.

My brain was super stimulated. So much so I did not even think of my family during class times.

And my friend Jun had to ask if I was in a mid-life crisis. I just love to learn new stuff.

Now let’s hope I can actually finish this course.

Do Not Feel “Sayang”

Sayang is a Filipino word that roughly means “what a waste”. But is is more than that. English doesn’t quite capture the context which this word is used. It is also used when you want to hold on to something because you already invested time or effort or capital. Or it could be used when you say a person is beautiful but Sayang, he/she is a motormouth or something negative that counteracts the positive quality of a person.

Dec 29, ’10

If I always think of having to recoup everything, I figure I may not recoup anything at all.  A cousin used to be like that and he would have a warehouseful of old stuff, gathering dust.

I figure if we sell at a loss, we could clear the space and get another chance at recouping the investment.  Sometimes, some of the older generation would comment on our practises.  “How are you going to make money that way?  Selling at a loss”.  But it is not all the time. 

Win some, lose some.  We can’t be perfect.  There will be times when we make the wrong call.  I have come to believe that it is better to quickly dispose of items that are not saleable even at a loss.  I don’t need to pay extra for warehousing and other inventory costs plus everytime these dinosaurs get out, it is more space for new items. 

I am of course talking about retailing but I suppose it could apply to life too.  Like relationships.  I remember a cousin who had been with her boyfriend for almost 7 years.  They got married because “sayang” the time they spent with each other.  Well, the marriage didn’t last.

Yea, one shouldn’t let the feeling of sayang weigh one down when making decisions about the future.  If the existing relationship feels tepid or boring or causes tensions and pressures, no matter if you’ve given up your virginity to this guy or you’ve invested several years of your youth, or you’ve pooled your finances – if it doesn’t feel right, better another chance with the unknown than one whose chances of success dim with every day that passes.

Toes

Another old post.

Nov 20, ’10

I’ve never been a fan of flipflops or any shoe that shows off my toes – all five of them in their naked glory.  I’m just not comfortable.  I don’t do pedicures.  I just trim nails and make sure they’re clean.  The most I can wear are peep toe shoes.

There are some feet that really look good in those flimsy sandals that show off the whole shebang.  But still I draw the line at bare feet in public places that are not beaches.  Bare feet especially in a restaurant grosses me out.  Even if they’re nice and clean and delicate, there’s something about seeing the soles that make me uncomfortable.

So I was really disappointed when this cute, spunky, proper young lady that I like, took off her sandals at the airport pre-departure area and propped up both bare feet onto her seat, toes wiggling from time to time .  Knees to chest seating position.  The feet were clean but it kind of bothered me.  I tried not looking at her feet but … it really bothered me.  It’s like I was seeing something private that I’m not supposed to see.

Maybe I am of a generation that is not this open with their lifestyle.  Except in beaches, shoes were required.  I could just be uptight.  But it really changed my view of this young lady’s family.  I still like her, her spunk reminds me of myself when I was younger, but somehow the admiration has diminished.  It might be a non sequitur; showing off one’s feet in a public place and being gracious and proper; but I can’t help it.  That’s me.